How can a birth doula help during childbirth?

When I was pregnant for the first time, I was very naive about pregnancy and birth. I presumed it was a horrible experience that you just got on with to get the end result. Luckily, my sister booked me onto a hypnobirthing course and my attitude towards birth completely changed. I felt excited and prepared for birth, and went on to have a great experience. Hypnobirthing is a great way to prepare for birth, but what if you feel you need a bit of extra support on the day? You might want to consider a doula. A doula is “a woman, typically without formal obstetric training, who is employed to provide guidance and support to a pregnant woman during labour.” To find out exactly what this means, I’ve put my top five questions to Ruth, a local Kent based doula.

As a birth doula, how do you support women on the big day?

The way I support women and birthing people on the day of their baby’s birth starts a long time before that day. Sometimes that is months before and sometimes it is weeks. The relationship that we build during your pregnancy means that you have someone you know with you from the first twinge. I don’t really think of birth and labour as being a single event. So often we want to know when it will start, how long it will be and what we can do to speed it up. But the work we do during pregnancy soothes some of those anxieties. When the first feeling of prodromal labour start you are ready and can go through the process however long.

In a practical sense, I am by my phone night and day waiting for information. Often we are in touch and the first contraction is no surprise. Parents always want to know when I will arrive, and the answer is it is up to them. I will come when they need me – I don’t see it as my job to second guess a woman’s instinct. I believe that if you want me there, there is a good reason for that.

Once with you, the comfort measures we have discussed in our antenatal meetings come into play; massage, TENS, water, rebozo, hypnobirthing scripts, affirmations, movement, essential oils, warmth, cold, drinks, snacks, meals, accupressure, spinning babies techniques, meditation, yoga, sleep, rest, walking, laughing, cuddles, oxytocin box, breathing. A doula is a tool the same that hypnobirthing is! Use me how you wish!

Sometimes you might ask me to support with a decision that needs to be made and I hold you and your partner’s space. I protect your right to make an informed choice and provide you with that information if you wish.

I don’t leave unless you are comfortable with that. Although, I may have to have a nap at some point! But that is where a tag team with your partner works perfectly, especially in longer births. Often the things that have been most useful for parents that I have supported are the things I was not doing. Being calm, being still, showing them there is nothing to fear, nothing to worry about.

If someone already has a birth partner, plus a midwife, isn’t that enough? Do they need a birth doula too?

Birth partners are often someone that we love most in the world. Often we are the one they love most and would protect with everything we have. It is very difficult to be an objective, calm and composed presence while your partner, daughter or friend is knackered and in pain. Often birth partners martyr themselves accidentally; they don’t sleep or eat and focus everything on their partner in labour. However well meaning and loving an act this is – it depletes them, and the energy around the birthing person. A step outside for a fresh walk, a proper lunch or a couple of hours kip can make the difference between a birth partner experiencing trauma or not. If a birth partner knows that the woman birthing is in safe hands and someone can come and get them if needed, they can really rest and recooperate. Birth is tough, it is powerful and can be super draining for everyone!

Midwives and doulas have such different responsibilities, such different tasks during labour. Doulas are responsible to their clients, midwives are responsible for the families they support. A lovely phrase I heard recently describing the teamwork between doulas and midwives was that for a great birth women have to feel “safe and supported”. Midwives provide the safe and doulas provide the supported.

In our sadly broken maternity system, our amazing NHS midwives just do not have the time to provide the kind of care they want to. They have to focus on medical risks and everything else is done if they have time. I always think it must be a relief for midwives when they see that a woman has people around her. People who know how birth works, and can support without a time limit and unconditionally.

What if someone doesn’t go into labour on time? Or too soon?

When is on time?! I go on call from 38 weeks gestation from your estimated due date, until you give birth. But, let’s be realistic here – babies come when they want to. If there is a reason that someone thinks they will birth early, we chat about it beforehand and come up with a plan for a longer on call time.

If you have a surprise early arrival I do all I can to get there on time. I also work with trusted backup doulas. That way, if I am at another birth someone else can make it to you if that is what you want.

A baby that takes a bit more time is no issue. I plan my work so that I take this into account. You have to be flexible and resilient as a birth doula. There is no early and late – there is just the time your baby comes.

What if the birth plan changes?

Birth plans basically always change. It isn’t silly to have a plan, a plan prepares you for all the options you might need to know about when something new arises or you change your mind. It’s ok to be informed and choose as you go along. Or to want one thing and then adapt if that doesn’t work out. It’s just a day like any other – it is unlikely that we can guess what will happen. I support all birth. A birth doula during a cesarean birth can be just as useful as a doula at a home water birth. It isn’t about the mode of labour, it’s all about how you feel about it.

What if someone is keen to use a birth doula, but their birth partner isn’t?

I guess that is a discussion for them to have and see who wins?! I have been to interviews where the partner doesn’t know much about doulas at all, and I’m happy to inform. However, I would never try to convince someone to use a birth doula! I passionately believe in everyone having the support they want (in everythin, not just birth!). If a doula isn’t wanted, then I’m sure they have reasons for that.

I know that I will forever wish that I had a birth doula for my first labour. I chose not to as I thought I knew everything I needed and could do it alone. Sometimes I feel that someone is making the decision in the way I had and it hurts my heart a bit that they might not have the support and wish they had. But I don’t know anyone’s full story and wouldn’t make the assumption that I know best for them – people have a right to their own choices and that includes not hiring a birth doula!

Thanks for the great questions Colleen! If anyone has any others I always love a chat about birth! You can reach me on 07886199300 or ruth@mothermother.co.uk. Or you can rifle through the info on my website www.mothermother.co.uk


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